Abstract
Purpose :
Vitrectomy is indicated in diabetes for non-clearing vitreous hemorrhage or tractional retinal detachment. In this registry-based study, we investigated the 26-year risk of diabetic vitrectomy and associated risk factors in all Danish patients, who had attended the national diabetic retinopathy (DR) screening program.
Methods :
This was a national, registry-based study of all patients attending DR screening in Denmark (2013-2022), who were mandatorily registered in the Danish Registry for Diabetic Retinopathy (DiaBase). Data of first-time diabetic vitrectomy was extracted from the Danish National Patient Register based on combined operative (vitrectomy: CKD65) and diagnostic (DR [H360] or vitreous hemorrhage [H431] or tractional retinal detachment [H334B]) coding. We excluded patients giving birth within 12 months before surgery.
Results :
Between 1996 and 2022, vitrectomy was performed in 52,824 Danes. Of those, diabetic vitrectomy was the indication in 11,385 (21.6%), with a decline from 36.4% in 1996 to 19.8% in 2022. Among 262,550 patients registered in DiaBase, 4,396 (1.6%) had at least one episode of diabetic vitrectomy. Multivariable adjusted odds ratios (OR) with 95% confidence intervals (CI) for diabetic vitrectomy were male gender (OR 1.08, 95% CI 1.01-1.16), duration of diabetes (OR 1.20 and 1.14 for patients with type 1 and 2 diabetes, respectively), never being married (OR 1.19, 95% CI 1.08-1.30), Charlson’s comorbidity score (OR 2.71, 2.35 and 2.43 for patients with levels 1-3), use of insulin (OR 1.73, 95% CI 1.56-1.91), antihypertensive therapy (OR 2.04, 95% CI 1.84-2.27), and level of DR at first screening episode (OR 3.80, 5.88, 13.28 and 45.55 for DR-levels 1-4, respectively).
Conclusions :
In a national cohort including all diabetic vitrectomies in Denmark in a 26-year span, surgery was more likely to occur in unmarried male patients with a long duration of diabetes. DR-level at the first screening episode was identified as the principal risk factor.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.